搜索结果：Image

To determine the feasibility of anatomical neuroimaging studies using 0.55 T MRI. MPRAGE images with 1 mm isotropic resolution were acquired from a cohort of five healthy subjects using both 0.55 T and 3 T scanners, including repeat scans of each subject at each field strength. The 0.55 T images were denoised to mitigate the effects of high resolution and low-field strength. All scans were analyzed using BrainSuite and FreeSurfer image analysis software, which performs operations including tissue classification, region segmentation/labeling, and thickness/volume measurements for different brain regions. Regional cortical thickness measurements and regional brain volume measurements were compared, and test-retest repeatability at each field strength was evaluated. For both image analysis software tools, we observed reasonably good correlations between field strengths for cortical thickness measures and regional brain volume measures. Test-retest repeatability analysis suggests that experimental variability was generally higher at 0.55 T than at 3 T, although the amount of difference was dependent on the specific measure being considered and the software tool that was used. While our sample size was small which limits the strength of the conclusions we can draw, this small-scale pilot study suggests the potential feasibility of certain types of anatomical neuroimaging studies at 0.55 T (especially those involving volume measurements), assuming that appropriate adjustments are made to account for increased experimental variability at this field strength.

The purpose was to examine how variations in AI output design affect radiologists' performance in interpreting chest X-rays. Eight readers interpreted 80 COVID-19 chest images under five AI conditions in this retrospective study: no feedback, one-word summary, graph, heatmap, and heatmap + graph. Reader accuracy and eye-tracking data were analyzed to assess diagnostic performance and efficiency. Performance data were analyzed using a generalized mixed model nested for cases within readers assuming a binary distribution and with sandwich estimation; eye-tracking data were analyzed with analysis of variance. Baseline accuracy for detecting COVID-19 without AI was high and remained largely consistent across all AI designs. Fewer than 1% of decisions changed from correct to incorrect (true positive → false negative; true negative → false positive) with AI, while approximately 1% of decisions improved (false negative → true positive; false positive → true negative). More complex AI displays, such as the combined heatmap + graph, were associated with longer interpretation times and increased gaze shifts between the clinical image and AI outputs. Providing well-designed AI output can increase diagnosis accuracy and visual search of chest images. Simpler displays may support faster decision-making, whereas complex visualizations could impose additional cognitive demands to process the additional information. However, accuracy improvements likely outweigh modest increases in viewing time. Optimizing the presentation of AI information is essential to integrate human expertise effectively and create a synergistic human-AI partnership in clinical imaging, where the human remains the ultimate decision-maker.

To develop a data-efficient, unsupervised deep learning framework for deformable SPECT/CT registration that supports voxel-based dosimetry in radionuclide therapy, particularly in clinical settings with limited imaging datasets. We propose Nufit-Reg, an unsupervised deep learning network for deformable SPECT/CT registration. The network employs dual Swin-Transformer-based encoders to process CT and SPECT images separately, with cross-stitch units enabling structured feature sharing and multimodal integration across hierarchical stages. To overcome data scarcity, a two-stage training strategy was adopted. In the first stage, inter-patient pre-training was performed using randomly paired iodine-131 SPECT/CT scans (a total of 58 scans) to learn general anatomical correspondences. In the second stage, few-shot fine-tuning was performed using intra-patient sequential SPECT/CT pairs derived from quantitative scans (12 patients, each with three time points), enabling the model to adapt to patient-specific temporal consistency while being optimized across multiple patients. Registration performance was evaluated against Elastix and UTSRMorph using image similarity metrics, including structural similarity (SSIM), weighted SSIM (wSSIM), local normalized cross-correlation (LNCC), and mutual information (MI), as well as deformation regularity assessed via Jacobian determinant analysis. The downstream impact of registration on voxel-level time-activity-curve (TAC) fitting and tumor dose distributions (D2%, D98%) was also quantitatively analyzed. Nufit-Reg achieved a superior weighted SSIM (0.8968 ± 0.0241). It significantly outperforming Elastix and CT UTSRMorph. In dosimetry analysis, the enhanced registration accuracy led to an 11.7% reduction in tumor fitting RMSE compared to Elastix. These improvements aligned with more stable dose distributions. This was evidenced by reduced D2% extremes (110.81 to 95.1 Gy), and higher median D98% 3.30 Gy. This study introduces Nufit-Reg, a two-stage unsupervised framework that achieves accurate and efficient deformable SPECT/CT registration under data-limited conditions. By combining inter-patient pre-training with intra-patient fine-tuning, Nufit-Reg provides a practical solution for supporting individualized voxel-based dosimetry in I-131 radionuclide therapy and potentially for other radionuclide treatments in data-scarce clinical environments.

Sickle cell disease (SCD) is a major global health burden, and early, accurate diagnosis is critical for effective management. Conventional diagnostic methods are often resource-intensive and inaccessible in high-burden, low-resource settings. Artificial intelligence (AI) and machine learning (ML) technologies have emerged as promising tools to automate and enhance SCD detection. This systematic review aimed to critically evaluate the diagnostic and predictive performance of AI and ML models for SCD detection and to assess their methodological quality and readiness for clinical implementation. A systematic search of PubMed, Web of Science, Scopus, and Embase was conducted for studies published between 2021 and 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Original research employing AI/ML models for SCD detection, classification, severity stratification, or outcome prediction was included. Data on study characteristics, model types, and diagnostic performance metrics were extracted. The risk of bias was assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). A narrative synthesis was performed due to substantial methodological heterogeneity precluding meta-analysis. Seventeen studies were included, demonstrating a diverse landscape of model architectures, including deep learning (DL) for blood smear image analysis, ensemble methods for classification, and prognostic models for pain and mortality prediction. Diagnostic performance was consistently high, with accuracies frequently exceeding 94% for image-based SCD detection and area under the receiver operating characteristic curve (AUC-ROC) values reaching up to 0.99 for ensemble classifiers. Prognostic models for mortality and readmission achieved C-indices and AUCs of 0.76 and 0.77, respectively. PROBAST assessment revealed that a majority of studies (14 of 17) had a low overall risk of bias, while three studies were rated as high risk due to small sample sizes and methodological reporting limitations. AI and ML models demonstrate substantial diagnostic accuracy and promising prognostic capability in SCD. However, the field remains at a proof-of-concept stage, with a predominant reliance on internal validation and a lack of standardized reporting that hinders direct model comparison. For these technologies to achieve clinical impact, a rigorous paradigm shift toward prospective, externally validated studies in high-burden populations, alongside strict adherence to emerging reporting standards, is essential.

Lichen planopilaris (LPP) is a rare, immune-mediated cicatricial alopecia characterized by perifollicular erythema, hyperkeratosis, and progressive hair follicle destruction, leading to permanent hair loss. While LPP typically affects the scalp and is classified into classic LPP, frontal fibrosing alopecia (FFA), and Graham-Little-Piccardi-Lassueur (GLPL) syndrome, atypical presentations involving extra-scalp regions, including the face, are exceedingly rare. We present a unique case of melasma-like LPP manifesting on the face, a highly unusual presentation that posed diagnostic challenges due to its resemblance to hyperpigmentary disorders. A 38-year-old man presented with an asymptomatic hyperpigmented patch on the cheek and forehead mimicking melasma. This case highlights the importance of considering LPP in the differential diagnosis of facial hyperpigmentation, particularly when conventional therapies for melasma fail. It should be noted that histopathology was a valuable tool for the diagnosis of the disease. We recommend including dermoscopic images in future studies to help dermatologists become familiar with the dermoscopic features of LPP and to differentiate between LPP and melasma using dermoscopy.

Objective This study aimed to assess the quality and readability of online information available to patients on Google regarding Gilmore's groin. Methods This descriptive cross-sectional study evaluated webpages identified through Google searches using the terms "sports hernia", "athletic pubalgia", "Gilmore's groin", "sportsman's hernia", and "hockey hernia". The first page of results for each search term was screened. Duplicate links, non-functioning pages, and irrelevant results were excluded. Unique webpages meeting the eligibility criteria were analysed. Readability was assessed using the Gunning Fog Index (GFI), Flesch-Kincaid Grade Level (FKGL), and Flesch Reading Ease (FRE) score. Each webpage was further evaluated for source type, intended audience, presence of relevant media, inclusion of key clinical information, and quality using the Journal of the American Medical Association (JAMA) benchmark criteria. Descriptive statistics were used to summarise the findings. Results A total of 26 unique webpages were included. Hospital or clinic websites accounted for 13 (50%) webpages, and 16 (62%) were primarily directed toward patients. Relevant images were present in 11 (42%) webpages and relevant videos in three (11.5%). Information on cause and symptoms was provided in 26 (100%) webpages, investigations in 22 (85%), treatment in 25 (96%), and prognosis in 15 (58%). With respect to JAMA benchmarks, authorship was reported in 16 (61.5%) webpages, attribution in 13 (50%), disclosure in 21 (81%), and currency in 17 (65%). Mean readability scores were 11.5 for GFI, 9.9 for FKGL, and 43.5 for FRE, indicating that the material was generally written above the recommended reading level for patient education resources. Conclusion Online patient information on Gilmore's groin is widely available but is typically written at a reading level that is too advanced for the general public. Improving readability while maintaining accuracy may enhance patient understanding, support shared decision-making, and improve access to health information.

Point-of-care ultrasound (POCUS) is increasingly incorporated into nephrology practice, yet comparative data on educational strategies and the durability of their effects remain limited. We conducted a questionnaire-based study to examine whether a structured workshop (WS) differs from on-the-job training (OJT) in shaping self-reported POCUS practice and confidence among early-career nephrologists. In August 2025, nephrologists with fewer than 15 postgraduate years at a single academic center were surveyed. Participants were categorized into three cohorts: those who attended a structured WS program (didactic lectures and hands-on training) in 2023, those who received OJT only in 2024, and those who received OJT only in 2025. All assessments were retrospectively reported at a single survey time point. Outcomes included self-rated confidence in examination frequency, technical skill, image interpretation, and mentoring others using a 5-point Likert scale. Thirty-four respondents (79.1% of all eligible nephrologists) were analyzed. In recalled post-training assessments, the WS group demonstrated higher confidence in interpretation and mentoring compared with OJT cohorts, whereas no differences were observed in technical skill or examination frequency. At the time of the survey, no significant between-group differences persisted. Within the WS group, confidence scores declined across all domains over time. In this exploratory study, structured workshops were associated with greater recalled post-training confidence in interpretative and mentoring domains, but these gains attenuated without reinforcement. Sustainable integration of nephrology-specific POCUS may require longitudinal, organization-supported educational frameworks rather than isolated instructional interventions, such as OJT alone.

To investigate the influence of gadolinium-based contrast agent (GBCA) administration on breast lesions' signal intensities on diffusion-weighted images and its derived ADC maps acquired 2 min after GBCA administration. An intra-patient analysis was performed. 110 lesions&#x2009;>&#x2009;5&#xa0;mm in 93 patients, visible on screening and pre-operative MRI scans at 1.5&#xa0;T and 3.0&#xa0;T, were included. Pre-contrast and post-contrast DWI were acquired with single-shot spin-echo echo-planar imaging (SSh-SE-EPI) with b0, b50, b150, and b800 diffusion weightings. 2D regions of interest were drawn. Each b value was separately analyzed regarding signal intensities on DWI. Furthermore, ADC values were compared based on the pairs b0-b800 and b150-b800. The comparison between pre- and post-contrast DWIs was investigated within and between different groups (overall, malignant/benign, and at 1.5/3.0&#xa0;T). The Wilcoxon-signed rank test and independent Student T test were used when appropriate. P&#x2009;<&#x2009;0.01 was considered as statistically significant. Overall, and for malignant and benign lesions separately, a significant change after contrast administration in signal intensity was observed at each specific b value, irrespective of the use of 1.5&#xa0;T or 3.0&#xa0;T. The effect of contrast administration was overall notably different when comparing b0 (+&#x2009;9.4%) vs. b800 (+&#x2009;11.8%), but this was not observed between b150 (11.4%) and b800 (11.8%) (P&#x2009;=&#x2009;0.10). In malignant lesions, specifically, all b value pairs, except b0-b50, showed significant differences in GBCA effects. This translates into a pre-post-contrast difference of the ADC value of 3.2% (P&#x2009;=&#x2009;0.02) when based on b0-b800 and 0.9% (P&#x2009;=&#x2009;0.11) when using b150-800. There is a limited, but significant effect of contrast administration on DW signal intensities measured 2 min after contrast administration. This effect is not the same for each b value. Signal change is stronger for high than for low b values, which leads to a larger change in measured ADC values after contrast administration when b0 and b50 are incorporated in the calculation. As a consequence, ADC calculations obtained from b150-b800 seem to be more robust than those obtained from b0-b800.

Androgenic alopecia (AGA) is the most common type of hair loss that occurs due to androgens, specially, dihydrotestosterone (DHT), and the 5-alpha reductase is the key enzyme to control AGA, as it is responsible for the conversion of testosterone to DHT, the more potent form of testosterone involved in the pathogenesis of AGA. Blockers of this enzyme suppress the conversion of androgens to DHT. Dutasteride is one of the 5-alpha reductase inhibitors and is frequently used as an anti-hair loss treatment. Gamma-oryzanol (GO) is an anti-oxidant and anti-5-alpha reductase, which has been introduced as an anti-hair loss treatment by some studies. The nanostructured lipid carriers (NLCs) were developed for targeting the dutasteride and GO in hair follicles. The NLCs were prepared from herbal oils pumpkin seed oil (PSO) and saw palmetto (SP), which also have a 5-alpha reductase inhibitory effect, contributing to the therapeutic effect. NLCs in follicular targeting enable to accumulation of the drugs in the target area (hair follicle cells), reduce the absorption of dutasteride in other organs and tissues, and reduce the side effects. NLCs were prepared by adopting a hot homogenization method and were characterized by particle size analyzer, scanning electron microscope, and X-ray diffraction. An in-vivo study was conducted using C57BL/6 mice to assess NLCs ability in drug delivery and accumulation in hair follicles. NLCs had great potentials for reducing the dutasteride daily dose. Moreover, the accumulation of NLCs was confirmed by histopathological images even after two weeks of the discontinued treatment. NLCs may have facilitated the follicular delivery of the anti-hair loss drugs. Since the NLCs have potential for accumulation in the hair follicles, the interval of formulation usage may have been increased to more than once a week which was of great interest to the practitioners aiming at developing more efficient formulations for androgenetic alopecia.

The utilization of stress perfusion cardiac magnetic resonance (CMR) in patients with cardiac implantable electronic devices (CIEDs) is still limited. The study was registered in the Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42023457308. PubMed, Scopus, Embase, Web of Science, ProQuest, and CINAHL databases were searched using the Mesh and related terms of CMR imaging, stress, and CIEDs. Out of the 1695 papers we found, eight met our inclusion criteria. We reviewed the included studies and provided a concluding remark concerning (a) image quality; (b) CMR compatibility, scanner, and safety; (c) device protocols and exclusion criteria; (d) vasodilator choices, effects, and safety; and (e) clinical outcomes. This study has demonstrated a positive trend in the utilization of stress CMR in MR-conditional devices. However, the review has identified multiple research gaps that warrant further investigation.

Metastable &#x3b5;-Ga2O3 holds promise for integrated neuromorphic memory and photosensing owing to its spontaneous polarization and low-temperature deposition compatibility. However, realizing its optoelectronic perception function is hindered by poor control over crystalline allotropes and complex defect-mediated carrier trapping. Here, we address these issues by achieving low-temperature (350 &#xb0;C) deposition of polycrystalline &#x3b5;-Ga2O3 with tailored photocarrier dynamics using reactive oxygen plasma-enhanced atomic layer deposition. This low-temperature strategy suppresses undesired phase transformation and enables defect engineering. Microstructure analyses confirm (002)-oriented polycrystalline &#x3b5;-Ga2O3 with a triple domain twinning architecture that yields macroscopic pseudohexagonal symmetry and reveal an orientation relationship of &#x3b5;-Ga2O3(002)//&#x3b1;-Al2O3(006) on c-plane sapphire. The &#x3b5;-Ga2O3 deep ultraviolet photodetectors exhibit a rapid recovery time of 0.03 s and a high detectivity of 8 &#xd7; 1011 Jones under a low bias of 1 V. At biases exceeding 10 V, persistent photoconductivity emerges, attributed to bias-addressed carrier trapping at oxygen vacancy defects of different energy depths. In neuromorphic mode, key synaptic behaviors&#x2500;paired-pulse facilitation, excitatory postsynaptic current, and spike rate-dependent plasticity&#x2500;are emulated, and high-accuracy image recognition is achieved. This work establishes a low-temperature growth strategy for &#x3b5;-Ga2O3 that integrates photodetection and neuromorphic visual functionality in a single material system.

The detection and characterization of hypoxia through functional imaging represents a critical frontier in oncology, cardiology, and neurology. Despite extensive efforts, the clinical translation of a robust hypoxia imaging biomarker remains hindered by suboptimal signal limiting diagnostic accuracy. Here, we report the development of a 64Cu-based radiotracer (64Cu-CysPhe), which exploits the cellular copper uptake pathway involving the human copper transporter 1 (hCtr1). This targeted mechanism facilitates selective tracer accumulation in hypoxic tissues. In-vivo PET-MRI imaging in a murine breast cancer model demonstrated tumor-to-muscle ratios exceeding 3.0 up to 24&#xa0;h post-injection. Notably, immunohistochemical analyses revealed that 64Cu-CysPhe preferentially localizes to hypoxic tumor regions while excluding necrotic cores, thereby providing information about a tumor's immediate microenvironment. Comparative analysis with established radiotracers, including 64Cu-ATSM and 18F-FDG, confirmed the sensitivity of 64Cu-CysPhe in detecting hypoxic tumor regions. These findings establish 64Cu-CysPhe as a promising candidate for non-invasive imaging of tumors.

To investigate the natural course of geographic atrophy (GA) in Japanese patients, with a focus on factors associated with the change of GA size over time and visual acuity decline. Retrospective, single-center observational study. We reviewed 40 eyes of 40 patients with GA and longitudinal fundus autofluorescence (FAF) imaging. Annual progression rates were calculated as square root-transformed (mm/year). Assessed factors included age, sex, smoking history, diabetes, hypertension, baseline best-corrected visual acuity (BCVA), baseline lesion size, foveal center involvement, choroidal thickness, FAF subtypes, and presence of subretinal drusenoid deposits (SDD). Visual outcomes were assessed as change in BCVA (&#x394;BCVA, logarithm of the minimum angle of resolution (logMAR)). Median age was 75.5 years; 50% of eyes had SDD. The median annual GA progression rate was 0.16 mm/year in square root units. Baseline GA area and the presence of SDD were independent predictors of GA progression (&#x3b2; = -0.0837, p = 0.015; &#x3b2; = +0.3064, p = 0.009, respectively). In multivariable analysis, baseline GA area also remained a significant predictor of visual deterioration (&#x3b2; = +0.1369, p = 0.002). When stratified by FAF patterns, there was significant worsening of BCVA in the Diffuse (p = 0.0027) and Banded (p = 0.0117) subtypes, whereas the None and Other subtypes did not show significant changes in BCVA over one year. SDD was identified as a significant risk factor for GA progression in Japanese patients. These findings improve understanding of natural history of GA in Japanese population and may inform risk stratification.

Malignant sacral involvement can cause severe, refractory pain that remains challenging to manage with systemic analgesics alone. Intrathecal drug delivery systems (IDDS) offer an effective alternative but often involves surgically implanted pumps. We present a case in which an intrathecal catheter, typically used as a lumbar drain, was successfully adapted for long-term use with an external pump to manage intractable cancer pain. A 54-year-old male with a history of recurrent rectosigmoid adenocarcinoma and sacral metastasis presented to the pain clinic with complaints of burning and tight pain in the lower back, buttocks, and lower extremities, associated with bilateral foot paresthesias. Pain was exacerbated by movement and significantly impacted sleep and mood. Imaging revealed a 6cm recurrent tumor invading the sacral foramina and involving the sacral nerve roots. The patient's pain remained poorly controlled despite high-dose opioids (Morphine Sulfate Tablet-Sustained Release (MST) 40 mg TID, Morphine Immediate Release (MIR) 10 mg PRN, Methadone 5 mg PO BID) and adjuvants, leading to frequent hospital admissions and emergency room (ER) visits. After a multidisciplinary discussion and obtaining informed patient consent, an intrathecal catheter (Lumbar Drainage Kit, Medtronic&#x2122;) was inserted at the L2-L3 level under sedation and fluoroscopic guidance, with its tip positioned at T9. The catheter was tunneled subcutaneously and connected to an external ambulatory infusion pump (CADD-Solis&#x2122;) via a 0.2-&#x3bc;m filter. A continuous infusion of bupivacaine 0.5mg/mL and fentanyl 10mcg/mL was initiated. Catheter site care was performed by the family using Chlorhexidine Gluconate dressings (3M Tegaderm&#x2122;), which were changed every 7-10 days. The intrathecal analgesia provided sustained pain relief for 66 days, achieving a 50% reduction in pain scores and a 30% reduction in systemic opioid requirements. The patient's sleep quality and ability to reposition in bed improved. Most notably, the frequent ER visits and hospital admissions were eliminated. No signs of catheter-related infection or dislodgement occurred. This case demonstrates that adapting an intrathecal lumbar drain catheter for use with an external infusion pump is a feasible and effective strategy for providing long-term palliative pain control in selected patients with a good safety profile. This approach, combined with meticulous family-led catheter care, can significantly improve patients' quality of life and reduce the burden on acute healthcare services.

Among various biodegradable polymers, polylactic-co-glycolic acid (PLGA) is one of most widely studied synthetic polymer for controlled and targeted drug delivery. PLGA is a smart polymer as it has stimuli-responsive behaviour. PLGA is approved by the US FDA for multiple therapeutic applications due to its biodegradability, biocompatibility and sustained-release behaviour. PLGA is commercially available as different molecular weights and copolymer ratios, which allow for tuning polymer behaviour to suit numerous applications. Different methods have been used to process PLGA into diverse morphologies, structures and sizes. Traditional PLGA processing methods face many limitations related to scalability and residual solvents. This review was limited to the emerging hot melt extrusion (HME), a more specific, solvent-free and highly scalable technology for fabricating PLGA-based formulations. Key operational parameters such as glass transition temperature, melt viscosity, and degradation behaviour are discussed alongside with the drug-related stability, dispersion and final solid-state properties that need several factors to be fine-tuned to offer a performance with optimal efficiency. This tunability of characteristics makes PLGA driven by HME ideal for fabrication with advanced manufacturing technologies to deliver surprisingly novel drug delivery platforms that can boost therapeutic efficacy and patient compliance across a range of clinical fields.

To use the RS-1 Glauvas (NIDEK) system to evaluate the effect of axial length (AL) correction on retinal thickness (RT) with optical coherence tomography (OCT). Observational, cross-sectional study. Between November 2023 and April 2024, 165 eyes from patients with diabetes underwent OCT imaging. RT was measured with and without AL-based magnification correction with the Early Treatment Diabetic Retinopathy Study (ETDRS) grid, which comprises three concentric circles (diameters; 1, 3, and 6&#xa0;mm), with the inner and outer rings divided into superior, temporal, nasal, and inferior sectors. Measurements were calculated using two settings: a fixed AL of 24&#xa0;mm (uncorrected) and the individually measured AL for each eye (corrected). The difference between uncorrected and corrected RT measurements was analyzed using Bland-Altman analysis. Linear regression analysis was performed to assess the association between AL and the measurement difference. The mean AL was 23.9&#xa0;&#xb1;&#xa0;1.2&#xa0;mm. Bland-Altman analysis for central subfield thickness (CST) showed a small mean difference between corrected and uncorrected measurements (bias -0.34&#xa0;&#xb5;m; 95% limits of agreement -6.32 to 5.63&#xa0;&#xb5;m). Linear regression demonstrated a significant positive association between AL and the difference in CST measurements (R2&#xa0;=&#xa0;0.70, p&#xa0;<&#xa0;0.0001), indicating that uncorrected measurements tended to underestimate and overestimate RT in eyes with shorter and longer AL, respectively. AL differences affect the effective OCT scan area and may influence RT measurements. Applying AL correction minimizes measurement bias caused by transverse magnification and improves the accuracy of RT assessment.

Atlanto-occipital assimilation (AOA), also known as atlas occipitalization, is a rare congenital craniovertebral junction anomaly characterized by partial or complete fusion of the atlas with the occipital bone. It often remains asymptomatic until adulthood, and presentation in childhood is rare. We report a nine-year-old boy with partial AOA who developed early-onset neurological symptoms. He presented with a one-year history of intermittent neck pain and transient right-hand clumsiness and numbness, which were provoked by neck extension. Imaging demonstrated a C1 hemiring, partial right-sided AOA, mild basilar invagination with the odontoid tip extending 6 mm above Chamberlain's line, mild occiput-C1 instability, and dynamic C1-C2 instability. MRI showed ventral cervicomedullary indentation without associated medullary signal abnormality, and the clivo-axial angle (CXA) was reduced to approximately 117&#xb0;. No other associated congenital anomalies were identified. Given the early neurological involvement, dynamic instability, and pathological clivo-axial angulation, occipitocervical fusion was performed using an occipital plate, C2 pedicle screws, and an autologous rib graft, without significant donor-site morbidity. The patient recovered uneventfully, with complete symptom resolution and preserved functional neck mobility. Six-month follow-up imaging confirmed stable instrumentation. This case highlights that neurological symptoms may occur in children with AOA even without marked static cord compression when dynamic instability and pathological clivo-axial angulation are present. Early stabilization may help prevent irreversible neurological deterioration in carefully selected pediatric patients.

To compare biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) for detecting clinically significant prostate cancer (csPCa), and to assess the impact of artificial intelligence (AI)-assisted bpMRI on diagnostic performance and biopsy-related outcomes in readers with different expertise. In this retrospective multi-reader study, 173 men referred for prostate mpMRI were evaluated by five radiologists (two experts, three basic readers) who scored bpMRI and mpMRI using PI-RADS v2.1. After a 45-day wash-out, the same readers reinterpreted bpMRI with concurrent AI decision support (available for 127 cases). Diagnostic performance for csPCa (ISUP&#x2009;&#x2265;&#x2009;2) and benefit-to-harm ratios were compared across protocols and reader groups. Mean area under the receiver operating characteristic curve was 0.820 for bpMRI and 0.819 for mpMRI (difference 0.001), indicating comparable diagnostic performance. In the AI subset, AI increased mean specificity from 59.7% to 67.8% while reducing sensitivity from 90.2% to 84.5%. Biopsy selectivity and efficiency improved (3.9 to 4.6 and 1.7-1.9), particularly in basic readers. The effect was significant in basic readers (McNemar p&#x2009;=&#x2009;0.012 for sensitivity, p&#x2009;<&#x2009;0.001 for specificity) but not in experts. bpMRI showed comparable performance to mpMRI for csPCa detection in routine practice. AI-assisted bpMRI improved biopsy efficiency in less-experienced readers at the cost of reduced sensitivity, warranting careful consideration of the trade-off between missed cancers and avoided unproductive biopsies.